Circuit and Patient Info (Blue Book)

Question 1

brain of the infant receives how much cardiac output?

Answer 1

34% of cardiac output

Question 2

why is the infant’s vascular system more elastic?

Answer 2

less atherosclerosis

Question 3

the respiratory rate of newborns is much higher than adults. what is it?

Answer 3

34 times per minute

Question 4

why are pediatric patients cooled much lower than adults?

Answer 4

the pediatric patient has a higher metabolic rate than the adult

Question 5

If the procedure is a Blalock-Taussig procedure, what is the diagnosis of the patient?

Answer 5

Tetralogy of Fallot

Question 6

what does the Blalock-Taussig procedure entail?

Answer 6

construction of a shunt to join the subclavian end to end with the pulmonary artery to move blood from the systemic circulation to the lungs

Question 7

normal arterial and venous cannulation for pediatric cases

Answer 7

usually aorta proximal to innominate artery or femoral for arterial cannulation

venous cannulation is usually bicaval

Question 8

what are usual cardiac index for children?

Answer 8

2.8 to 3.2

Question 9

flow rates for larger children

Answer 9

60 to 80 ml/kg/min

Question 10

flow rates for infants

Answer 10

80-150 ml/kg/min

Question 11

flow calculated

Answer 11

BSA x cardiac index

Question 12

is hemoglobin higher or lower in peds compared to adults

Answer 12

is higher than that of adults

Question 13

polycythemia is usually found in many patients. what is that? and why?

Answer 13

polycythemia is abnormally high RBC count

may be present due to the compensation from poor oxygenation

Question 14

what is the cause of poor oxygenation in peds?

Answer 14

right to left shunt

Question 15

normal colloid osmotic pressure in pedi

Answer 15

25 mmHg

Question 16

what is COP lessened by?

Answer 16

priming solutions

Question 17

what helps achieve an acceptable COP level in priming solutions?

Answer 17

albumin

Question 18

what happens if 25% albumin is not added to priming solutions?

Answer 18

the COP would fall to a level hat would cause interstitial fluid buildup

albumin reduces platelet loss by inhibiting aggregation to the perfusion circuit

Question 19

what does the addition of large amounts of crystalloid solutions do to the vasculature?

Answer 19

allows the fluid to exit the capillaries and not return

in patients with normal COP, the fluid would reenter the capillaries

Question 20

how big are colloid particles and what does that do to the COP?

Answer 20

40-50,000 Daltons

this helps increase the COP and cause fluid, that is forced out o the capillaries by the arterial blood pressure, to reenter the vascular system in search of equilibrium

Question 21

minimum FFP level

Answer 21

100 mg/dl

Question 22

each milliliter of 12.5 gm, 25% albumin provides the osmotic pressure of _ml of plasma

Answer 22

5ml of plasma

Question 23

heparizined blood can only be kept for

Answer 23

48 hours

Question 24

why is heparizined fresh whole blood commonly used in neonatal blood?

Answer 24

because the bilirubin in this blood is much lower than that of stored blood and the citrate from CPD is not present. this Is advantageous since the enzymes required to break down bilirubin are not mature in neonatal liver

Question 25

when is mannitol given and why?

Answer 25

usually during rewarming it increases osmolarity of the glomerular filtrate which increases sodium, potassium, and urine output

Question 26

most authorities feel that it is best to keep the arterial blood pressure above

Answer 26

50 mmHg

Question 27

if the pressure does not rise to normal levels after a few minutes, it may be necessary to add antihypotensive agents such as

Answer 27

neosynepherine (phenylephrine)

Question 28

what is neosynephrine

Answer 28

powerful and selective alpha 1 receptor agonist that causes constriction of blood vessels

Question 29

drugs commonly used for hypertension

Answer 29

``` forane halothane regitine nitride fentanyl or sodium pentothal ```

Question 30

what can halothane cause?

Answer 30

hepatic toxicity

Question 31

arterial pO2 should not be excessively high in infants for what reason?

Answer 31

retinal damage is caused by excessive oxygen administration in newborns

Question 32

in premature infants retinal damage has occurred when the arterial oxygen pressure was greater than __mmHg for over 1 to 2 hours

Answer 32

110 mmHg

Question 33

electroencephalographic activity disappears at

Answer 33

15-20 degrees C

Question 34

what are ways that the perfusionist can prepare the patient for the acidosis that occurs with circulatory arrest

Answer 34

- bring patient to an alkalotic state - giving sodium bicarb and blowing off CO2 in greater amounts -

Question 35

how can you prevent acidosis during circulatory arrest?

Answer 35

allows the blood in the oxygenator to again be Brough to an alkalotic state with low pCO2 before flows are resumed

Question 36

T/F low urine output is common in pediatric patients

Answer 36

T